View full sizePhoto courtesy of Fred StovelFred Stovel's 92-year-old mother-in-law asked an ambulance from Tillamook County General Hospital for a Band-Aid last summer after a scratch wouldn't stop bleeding at last summer's Fourth of July parade in Manzanita.

A fellow parade-goer bumped into Fred Stovel's 92-year-old mother-in-law at Manzanita's Fourth of July party last summer, leaving a scratch that just wouldn't stop bleeding.

Stovel asked about a Band-Aid as the beach town's volunteer fire squad marched by, and the crew directed him to the Tillamook County General Hospital ambulance parked at their station.

"We walked over and as they offered help, my mother-in-law was clear: 'I don't want anything that's going to cost money," said Stovel, adding that they were careful to not go inside the ambulance for fear of incurring a charge. The medics, employed by the hospital, "didn't say it would be on the house or anything, but they said, 'Don't worry about it.'"

So Stovel's mother-in-law eased onto the edge of the rig's doorway as EMTs checked her vital signs, cleaned the wound and applied a bandage to her leg.

In November, a bill for $765 arrived.

Just as you'd expect a bandage to smart a bit when it's ripped off, it's safe to figure you'll pay for anything that comes out of the shiny white doors of an ambulance. That's especially true in remote areas, where insurance and health care experts say it's expensive to keep highly trained ambulance crews on hand for events such as a coastal parade.

In his understandable I'm-not-going-to-pay-$765-for-a-bandage ire, Stovel spoke with the hospital several times about the issue and said he was told its representatives would look into his complaint. Meantime, Medicare and the family's insurance company denied the claims. Both groups typically cover such bills if patients are actually driven to the hospital in an ambulance, hospital and insurance specialists said.

Three bills and two months later, Stovel said last week that all he'd heard from the hospital was a potential 10 percent discount off the bill. Frustrated, he called The Desk, which charges nothing for a little help -- or a Band-Aid for that matter.

The Desk called the Adventist Health-owned hospital and talked to Gina Seufert, a patient representative. She said that although the Stovels may have gotten the idea the help from the EMTs was free, that message probably didn't come from one of the hospital's employees.

"These were legitimate services and they were billed appropriately," Seufert said. "We wouldn't charge $765 for the application of a Band-Aid, I can guarantee that."

When potential patients seek help from an ambulance, she said, there are typically additional services provided even if someone refuses to be rolled on to the hospital. Medics check vital signs to be sure that an injury or fall wasn't the result of something else, say a heart issue or stroke.

"We do all that treatment, offering to clean wounds, apply dressings, all those different things," she said. "It's a full range of services, not the single application of a Band-Aid."

Seufert recommends that if people need help, but it's not an emergency, they should have a careful conversation with ambulance medics, not police or other on-site responders. Ask what services might cost and whether a private company or a hospital owns the ambulance. When problems arise, ask for an itemized bill and seek out such "patient representatives" at the hospital.

Seufert said the hospital already had decided to toss out Stovel's bill, but that sometimes those decisions just take some time.

Stovel's happy and plans to sign up for a $60-a-year membership program through Tillamook General that ensures ambulance visit to his house will be covered, even if no one decides to head to the hospital. And yes, he made sure his mother-in-law will be covered.

Nice, yet the Good Doctor Desk recommends first checking out any insurance-like programs through the Oregon Insurance Commission (1-888-877-4894).